GRASSROOTS/Hank Kalet

Jobbed on
Health Care

Bold new solutions need to be considered to address the growing health care crisis.  Elise Gould, The Erosion of Employer-Sponsored Health Insurance, a report from the Economic Policy Institute

Anyone looking for evidence that the American healthcare system is irreparably broken should read a report issued in October by the Economic Policy Institute.

The report, The Erosion of Employer-Sponsored Health Insurance, quantifies what most people know intuitivelythat fewer and fewer of us are being covered through our employers.

It was the seventh straight year that EPI found that the share of persons covered through work (either their own or a family members employer), with the trends indicat(ing) a significant shift from private to public coverage, especially among children to make up the gap.

The report, written by Elise Gould, showed a 5.4-percentage-point decline in employer coverage, 68.3% to 62.9%. That meant that more than 3 million fewer Americans under the age of 65 were covered in 2007 than in 2000, which does not even account for the fact that the under-65 population grew by over 16 million in this period.

Gould writes that employer coverage fell across all demographic groups, though some were more hurt than others. Children, for instance, were down 6.5 points, adults 18-24 were down 5.1 points and those 25-54 were down 6.1%. The report also found racial and ethnic disparities70.8% of whites have coverage, compared to 51.6% of blacks and 41.4% of Hispanics, while 65.1% of native-born Americans and 47.4% of immigrants.

Supporters of the status quo or free-market medicine might use the report to claim that health coverage is on the risethe number uninsured fell by 1.5 million from 2006 to 2007, though it remains 18% higher than in 2000. But that would ignore a key point, that it is public insurancenot other forms of private coveragethat is picking up the slack.

The report cited two programsMedicaid and the State Childrens Health Insurance Programthat mitigated the rising uninsurance rates across the entire under-65 population.

Medicare serves to protect older Americans, but Medicaid/SCHIP is the main source of public coverage for poor and near-poor children, the report says. In 2007, 28.1% of children had Medicaid/SCHIP, having risen every year except one since 2000, for a gain of 7.2 percentage points in all. While some of these coverage trends may be due to crowd-out, it is clear that if not for public insurance, the overall coverage rate among children would have fallen.

Once you back children out of the calculation to account for SCHIP and look only at adults, you find just how badly our healthcare system is failing us. Nearly one in five workers between the ages of 18 and 64 (18.1%) are uninsured, or about 26.8 million adults.

Because of these large declines in employer-provided health insurance, workers and their families have become uninsured at alarming rates, the report says. While there was a small gain in overall coverage for workers from 2006 to 2007, there were over 4 million more uninsured workers in 2007 than in 2000. Uninsured workers are disproportionately young, non-white, less educated, and low wage, however, workers across the socio-economic spectrum experienced losses in coverage over the 2000-07 period. Even the most highly educated and highest wage workers had lower rates of insurance coverage in 2007 than in 2000.

The report should be a wakeup call to American politicians who, so far, have been timid about doing anything more than nibbling around the edges. During the primaries, the three major Democratic candidatesBarack Obama, Hillary Clinton and John Edwardsall proposed expanding coverage (the GOP offered tax credits) but none offered a single-payer, universal plan, which is what the report calls for.

The current system, the report says, which uses public insurance only as a safety net to insulate people from events such as job loss, illness, or natural disaster or help people who have limited access to or are unable to afford private health insurance, is full of cracks.

Clearly, Gould writes, there are many Americans who are falling through the growing gulf between employer-sponsored coverage and government health programs.

The answer, as the report says, is to create a universal system that provides a minimum standard of care to everyone. Such a system, the report says, would provide Americans with access to the type of health care appropriate for the most prosperous nation in the world.

Hank Kalet is a poet and the managing editor of the South Brunswick Post and The Cranbury Press in Dayton, N.J. E-mail grassroots@comcast.net. See his blog, Channel Surfing, at www.kaletblog.com.